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Miscellaneous: Claims Adjustments
Claims
Claims Adjustments
Claims
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CHARGES
COB
DATE
DIAGNOSIS
MEDICARE
PLACE
PROCEDURE
PROVIDER
SUBSCRIBER
G
V
B
D
L
C
E
N
O
V
S
S
M
G
R
U
H
Q
N
M
U
X
I
E
E
P
E
M
V
K
B
L
D
S
R
R
T
K
G
D
S
Z
O
O
O
U
A
Q
X
Q
C
O
B
N
P
N
D
C
H
A
R
G
E
S
C
Z
G
E
I
P
I
H
V
K
E
A
L
A
C
D
B
L
X
S
G
V
U
F
I
O
E
M
E
A
Z
F
I
I
D
D
R
M
O
B
C
C
T
R
I
E
Q
P
R
O
V
I
D
E
R
A
D
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